About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Understanding Supraventricular ECG Findings
Introduction
Electrocardiography (ECG) is a crucial diagnostic tool for identifying heart rhythm disorders. A supraventricular rhythm originates above the ventricles, typically from the atria or the atrioventricular (AV) node. These rhythms can be normal or indicative of an arrhythmia.
Supraventricular Rhythms and Arrhythmias
1. Normal Sinus Rhythm (NSR)
- Originates from the sinoatrial (SA) node.
- Regular heart rate: 60-100 beats per minute (bpm).
- P-waves present before each QRS complex.
2. Supraventricular Tachycardia (SVT)
- Fast heart rate: >100 bpm.
- Common causes: Atrioventricular reentrant tachycardia (AVRT), AV nodal reentrant tachycardia (AVNRT), atrial tachycardia.
- ECG findings: Narrow QRS complexes, regular RR intervals, hidden or different-looking P-waves.
3. Atrial Fibrillation (AF)
- Irregular rhythm, varying heart rate.
- No distinct P-waves, replaced by fibrillatory waves.
- Increased risk of stroke due to blood clot formation.
4. Atrial Flutter
- Regular or variable rhythm, usually around 300 bpm with 2:1 or 3:1 AV conduction.
- Sawtooth pattern of P-waves (flutter waves).
5. Premature Atrial Contractions (PACs)
- Early heartbeats originating in the atria.
- Early P-wave with abnormal morphology, followed by a normal QRS complex.
Diagnostic Approach with ECG
- Step 1: Analyze the heart rate (tachycardia >100 bpm, bradycardia <60 bpm).
- Step 2: Look for P-waves (present vs. absent, regular vs. irregular).
- Step 3: Assess Regularity (AF is irregular, SVTs tend to be regular).
- Step 4: Measure PR and QRS intervals.
Clinical Implications
- Sudden fast rhythms may cause dizziness, palpitations, or syncope.
- Patients with atrial fibrillation require stroke prevention measures (anticoagulation therapy).
- Some SVTs can be stopped by vagal maneuvers or may require medical therapy (beta-blockers, calcium channel blockers, or antiarrhythmics).
- Advanced therapies include catheter ablation for recurrent cases.
Conclusion
ECG is an invaluable tool in diagnosing supraventricular arrhythmias, guiding appropriate treatment to reduce symptoms and complications like stroke or heart failure. If abnormalities are detected, further evaluation by a cardiologist is essential.
Source recommendations
1. American Heart Association (AHA) Guidelines on Supraventricular Arrhythmias
- https://www.ahajournals.org/doi/10.1161/cir.0000000000000311
- https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/tachycardia--fast-heart-rate
- https://pubmed.ncbi.nlm.nih.gov/14557344/
- https://www.ahajournals.org/doi/10.1161/01.cir.0000091380.04100.84
- https://pubmed.ncbi.nlm.nih.gov/14563598/
2. European Society of Cardiology (ESC) Guidelines on Supraventricular Tachycardia
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Supraventricular-Tachycardia
- https://academic.oup.com/eurheartj/article/41/5/655/5556821
- https://pubmed.ncbi.nlm.nih.gov/31504425/
- https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2019/09/10/12/36/2019-ESC-Guidelines-for-Supraventricular-Tachycardia
- https://pubmed.ncbi.nlm.nih.gov/14557344/
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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